Surgical management of marginal ulcer sequelae after Roux-en-Y gastric bypass: a single-center retrospective cohort study.

Background: Marginal ulcer (MU) is a rare complication following Roux-en-Y Gastric Bypass (RYGB). If left untreated, MU can progress into severe sequelae, including ulcer stenosis, gastrogastric fistula (GGF), or perforation. The aim of this study is to describe the surgical management for each of the three types of MU sequelae and to evaluate the risk of ulcer recurrence and the impact on weight loss following Revisional Bariatric Surgery (RBS).

Flexible robotic platforms for surgical applications in microgravity environments: a comprehensive systematic review of minimally invasive mechatronic systems and the impact of artificial intelligence on behalf of the Center for Space Systems (C-SET) & TROGSS-The Robotic Global Surgical Society.

The advent of minimally invasive surgery (MIS) in the 1990s marked a transformative shift in surgical practice, leveraging advanced robotic-assisted systems (RAS) for enhanced precision, dexterity, and improved patient outcomes. Over the past two decades, the surgical field has expanded from a handful of platforms to over 20 commercially available systems, some of them with artificial intelligence (AI) capabilities to varying degrees. While these advancements have redefined conventional surgical care, the unique challenges of space exploration, including microgravity, necessitate the adaptation of flexible robotic systems with AI.

Outcomes of simultaneous endoscopic transoral outlet reduction and gastric bypass distalization for the management of weight loss failure after Roux-en-Y gastric bypass.

Background: There are numerous revisional surgery options for weight loss failure after Roux-en-Y Gastric Bypass. To date, there are no studies that assess the weight loss outcomes of single-stage endoscopic revision of the gastrojejunostomy (GJ) (TORe) in biliopancreatic (BP) limb distalization. We aimed to report our experience with single-stage TORe and distalization.

Post Roux-en-Y Gastric Bypass Challenges: Gastrogastric Fistula After Marginal Ulcer Development.

Background: Gastrogastric fistula (GGF) is a rare complication following Roux-en-Y gastric bypass (RYGB). Various causative factors, including marginal ulcer (MU), can predispose to GGF development. Currently, no studies address surgical management of GGF after MU diagnosis.

Outcomes Comparison Between Primary and Revisional Duodenal Switch in Patients with a BMI Greater than 55 kg/m.

: Revisional bariatric surgery for recurrent weight gain is becoming more common, though it carries higher risks and may be less effective than primary bariatric surgery. This study compares clinical outcomes between primary and revisional duodenal switch (DS) in patients with a body mass index (BMI) > 55 kg/m. : A retrospective cohort study was conducted on 20 patients who underwent either primary or revisional duodenal switch (DS) surgeries, including biliopancreatic diversion with duodenal switch (BPDDS) and Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-s), between January 2015 and December 2023.

Outcomes of esophagectomy in patients with previous foregut surgery: a matched retrospective cohort study.

Background: Esophagectomy is a challenging procedure indicated for esophageal cancer and complex benign esophageal conditions. The primary aim of this study was to determine the impact of previous foregut surgeries on postoperative outcomes following esophagectomy.

Methods: A retrospective cohort study was performed on patients undergoing esophagectomy between March 1st, 2008, and December 17th, 2024.

Surgical management of candy cane syndrome after Roux-en-Y bypass.

Background: Candy cane (CC) syndrome is a complication that occurs following Roux-en-Y bypass (RYGB), implicated as a long, small-bowel blind limb at gastrojejunostomy possibly caused using circular staplers.

Objectives: We aimed to report our experience with CC resection and improving outcomes following RYGB.

Setting: University hospital.

Robotic versus laparoscopic revision to Toupet fundoplication for failed Nissen fundoplication: a single-center experience.

Nissen fundoplication (NF) is a common surgical procedure to treat gastroesophageal reflux disease; however, a subset of patients may continue to experience symptoms or develop symptom recurrence despite a successful procedure. This study aims to compare laparoscopic and robotic approaches for treating failed NF and evaluate the outcomes after converting to Toupet fundoplication (TF). We conducted a retrospective analysis of patients who underwent robotic or laparoscopic revision to TF for failed NF between 2016 and 2023.

Predictors of postoperative bleeding after minimally invasive bariatric surgery.

Background: Minimally invasive bariatric surgeries provide effective weight loss with fewer complications. However, postoperative bleeding remains a significant concern due to its potential for serious morbidity and mortality. This study aimed to identify factors predicting postoperative bleeding following laparoscopic and robotic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).

Concurrent minimally invasive bariatric surgery and ventral hernia repair with mesh; Is it safe? Propensity score matching analysis using the 2015-2022 MBSAQIP database.

Background: Obesity is a risk factor for the development of ventral hernias. Approximately eight percent of patients undergoing bariatric surgery have a concomitant ventral hernia. However, the optimal timing of hernia repair in these patients is debated.

Increased staple line leak rates following re-sleeve: analysis comparing re-sleeve versus Roux-en-Y gastric bypass conversion and primary sleeve gastrectomy.

Background: Sleeve gastrectomy is the most common bariatric procedure and its long-term complications include inadequate weight loss, weight regain, and de novo GERD, often requiring revisional surgery. Revisions, notably re-sleeve and conversion to Roux-en-Y gastric bypass (RYGB), are frequently performed, but safety data is limited. Herein, we used the MBSAQIP database to compare 30 day outcomes of primary sleeve gastrectomy (SG) with re-sleeve (RS) and SG to RYGB conversion.

Challenges of Revisional Metabolic and Bariatric Surgery: A Comprehensive Guide to Unraveling the Complexities and Solutions of Revisional Bariatric Procedures.

Revisional metabolic and bariatric surgery (RMBS) presents unique challenges in addressing weight loss failure or complications arising from initial bariatric procedures. This review aims to explore the complexities and solutions associated with revisional bariatric procedures comprehensively, offering insights into the evolving terrain of metabolic and bariatric surgery. A literature review is conducted to identify pertinent studies and expert opinions regarding RMBS.

A superior approach? The role of robotic sleeve gastrectomy in patients with super super obesity using the 2019-2022 MBSAQIP database.

Background: Laparoscopic sleeve gastrectomy (LSG) in patients with BMI ≥ 60 presents technical challenges, that might be overcome by robotic surgery, but its effectiveness has not been rigorously evaluated. We compared the 30-day outcomes of LSG and robotic sleeve gastrectomy (RSG) in patients with BMI < 60 versus ≥ 60 and between LSG and RSG in patients with BMI ≥ 60.

Methods: Patients aged 18-65 years who underwent sleeve gastrectomy were included using the 2019-2022 MBSAQIP database.

Outcomes of Sleeve Gastrectomy in Patients With Organ Transplant-Related Immunosuppression.

Introduction: Obesity is frequent among organ transplant recipients, increasing the risk of acute graft rejection and overall morbimortality. Laparoscopic sleeve gastrectomy (LSG) effectively improves graft survival and associated comorbidities. We first compared 30-d outcomes between chronic immunosuppressed (CI) and nonchronic immunosuppressed (non-CI) patients.

Early Marginal Ulcer After Roux-en-Y Gastric Bypass: MBSAQIP Database Analysis of Trends and Predictive Factors.

Purpose: Marginal ulcer (MU) is a known complication after Roux-en-Y gastric bypass (RYGB) that carries significant morbidity. First, we aimed to determine the trends and the rates of readmission, reintervention, and reoperation of 30-day MU. Second, we aim to determine the predictive factors associated with this complication.

Impact of Body Mass Index ≥35 kg/m on Minimally Invasive Adrenalectomy.

Obesity is associated with numerous chronic conditions and an increased risk for surgical complications. Laparoscopic and robotic adrenalectomy have proven effective in the resection of adrenal tumors. This study analyzes the outcomes of severely obese patients (body-mass index [BMI] ≥35 kg/m) following minimally invasive adrenalectomy.

Experience of Robotic Complex Revisional Bariatric Surgery in a High-Volume Center.

Purpose: A revisional bariatric surgery (RBS) is necessary in about 28% of the patients. The role of robotic surgery in RBS is still a subject of debate. We aim to report the outcomes of robotic-assisted RBS at our institution.

Do sleeve gastrectomy and Roux-en-Y gastric bypass have different venous thromboembolism risk factors? Creation of 30-day Bariatric Hypercoagulation Score.

Background: Venous thromboembolism (VTE) is a major cause of morbidity and mortality after bariatric surgery, most often occurring after discharge within 30 days after surgery.

Objectives: To determine the risk factors associated with VTE after either sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) and to develop a Bariatric Hypercoagulation Score (BHS) to predict 30-day adverse postoperative outcomes.

Setting: University hospital.

Feasibility and Outcomes of Simultaneous Gastric Bypass with Paraesophageal Hernia Repair in Elderly Patients.

Background: Paraesophageal hernias (PEH) have a higher incidence in patients with obesity. Roux-en-Y gastric bypass (RYGB) with concomitant PEH repair is established as a valid surgical option for PEH management in patients with obesity. The safety and feasibility of this approach in the elderly population are not well elucidated.

Do advances in technology translate to improved outcomes? Comparing robotic bariatric surgery outcomes over two-time intervals utilizing the MBSAQIP database.

Background: This study aims to compare outcomes and utilization of robotics in bariatric procedures across two-time intervals, chosen because they correspond to drastic changes in technology utilization-namely, a new platform and a new stapling device. Outcomes of robotic Roux-en-Y gastric bypass (rRYGB) and robotic sleeve gastrectomy (rSG) across this changing landscape have not been well studied, despite increasing popularity.

Methods: The MBSAQIP database was analyzed over early (2015-2016) and late (2019-2020) time intervals.

Laparoscopic sleeve gastrectomy to Roux-en-Y gastric bypass conversion versus primary Roux-en-Y gastric bypass: a propensity score matching analysis.

Background: Secondary bariatric surgery rates have increased, accounting for approximately 19% of the total bariatric cases in the last years, most commonly conversion of sleeve gastrectomy to gastric bypass. Using the MBSAQIP, we evaluate the outcomes of this procedure compared to the primary RYGB surgery.

Methods: The new variable, conversion of sleeve gastrectomy to RYGB in the 2020 and 2021 MBSAQIP database was analyzed.

Comparative outcomes of bariatric surgery in patients with ESRD on dialysis in the modern era of renal transplantation: analysis using the 2015-2020 MBSAQIP database.

Background: Severe obesity is a relative contraindication for renal transplantation, therefore bariatric surgery is an important option as a pre-kidney transplant weight loss strategy. However, comparative data regarding postoperative outcomes of laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients with or without ESRD on dialysis are scarce.

Methods: Patients between 18- and 80-year-old who underwent LSG and RYGB were included.